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metha 2010 chp 23
Microbial Diseases of the Urinary and Reproductive System
| Question | Answer |
|---|---|
| I. Diseases of the Urinary System | The urinary system normally does not contain many microbes- but opportunistic infections can be a problem. * Almost all infections are bacterial. * Most nosocomial infections are associated with urinary catheters- and 50% of these are caused by Escheric |
| * Symptoms: | painful urination or a sensation that the bladder is not empty even after urination; cloudy or a bloody tinge in the urine |
| * Bacteria are usually cultured to determine antibiotic sensitivity. | |
| A. Cystitis | 1. Common inflammation of the bladder- greater occurrence in females caused by E. coli (80%)- but also Staphylococcus saprophyticus (5 to 15% of cases)- and Proteus mirabilis |
| B. Kidney infection: Pyelonephritis | Untreated cystitis may lead to inflammation one or both of the kidneys.- fever and back pain. |
| A. Vaginitis and Vaginosis | |
| 1. Candida albicans: fungal disease | diagnosed by budding cell Normal flora usually not contagious- but can spread through direct contact – secretions – discharge- inflammation- painful ulcerations- and itching c. Low pH and normal vaginal anaerobes keep Candida in check; Normal T-cell ac |
| 2. Trichomonas vaginalis : trichomoniasis- a “trich” infection | a. STD - strict protozoan parasite of the human reproductive tract; acidophile c. symptoms – green discharge; odor; painful urination; small mucosal lesions; diagnostic feature: 4 flagella; d. R - Flagyl (metronidazole) e. Infection connected to increas |
| . Gonorrhea – Neisseria gonorrheae | a. STD that is caused by a bacterium that may cause discharge- painful urination- pelvic inflammatory disease (PID) in women; damage to the reproductive system causing sterility in both men and women; may be asymptomatic - 10% of males and 50% females b. |
| 2. Chlamydia trachomatis | a. Also called NGU: Non-Gonococcal Urethritis because symptoms mimic gonorrhea but much more common; the most common STD in the USb. C in TORCH; inclusion conjunctivitis – bacterium contracted as the baby passes through the birth canal but does not cros |
| C. Ulcer-causing diseases 1. Syphilis a. Caused by the bacterial spirochete | Treponema pallidum b. Three clinical stages – primary- secondary- and tertiary syphilis; spirochete is present in the lesions and blood and is transmissible in only the primary and secondary stages and intermediate stage before tertiary syphilis c. Prima |
| 2. Genital Herpes a. Usually caused by herpes simplex virus type 2 HSV-2; HSV-1 is primarily responsible for cold sores- but cases have with the reverse from autoinoculation or by oral sexual contact | |
| b. TORCH | |
| 1) Neonatal herpes - | virus can cross the placenta and infect the fetus causing spontaneous abortion or disrupted development – more likely if mother acquires the infection during pregnancy |
| 2) Infection of the newborn through the birth canal - may be lethal; can infect the nervous system; Cesarean delivery | |
| c. Human carriers; Transmission: mainly persons with active lesions; asymptomatic carriers; remains infectious in moist secretions on inanimate objects for a few hours | |
| d. Latent and recurrent attacks | |
| 1) nonactive virus remains inside the cranial nerves (HSV-1) or spinal nerve trunk (HSV-2); recurrent infection triggered by change | |
| 2) men are more likely than women to experience recurrences | |
| 3) 88% with HSV-2 and 50% with HSV-1 will have recurrences within 6 months | |
| e. genital herpes initially - nausea- fever- tenderness in the groin; virus migrates to the body surface- produces vesicles- often the same site as before | |
| f. Suppression and management but no cure; prevention crucial; condoms ineffective | |
| D. Wart Diseases | |
| 1. Genital Warts a. Human papillomaviruses – HPV | . Many serotypes; over 100 strains- 30 of these are STDs; HPV-16 and HPV-18 linked to cervical cancer with HPV-16 causing >50% of the cervical cancer in the US |
| c. Ubiquitous; epidemic; According to the CDC: | |
| 1) Most infected individuals are asymptomatic | |
| 2) Fifty to 75% of sexually active men and women acquire genital HPV infection at some point in their lives. | |
| 3) About 5.5 million Americans get a new genital HPV infection each year. | |
| 4) Ninety percent of women infected with cervical HPV will clear the virus- but of those that do not- the risk of cervical cancer is extremely high approx 4-500 women died of cervical cancer in 2001. | |
| d. Transmission: direct contact or indirect with a fomite; autoinoculation | |
| e. Incubation period: 2 wk to > 1 yr | |
| f. Known to convert warts into malignant tumors; strong association with cancer of the reproductive tract in both men and women | |
| g. Prevention extremely important - condoms ineffective; Treatment - Difficult to completely destroy | |
| h. Vaccine 1) HPV | types 6- 11- 16 and 18 available and recommended for 11-12 year old girls but may be given to females from 9-26 and is encouraged before women become sexually active;2) not known if effective in boys; not advised for pregnant women 3) series of three inj |
| 2. Molluscum contagiousum – | waxy- wart-like growths caused by a poxvirus in the membranes |
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